Описание
Phenytoin reduces topiramate plasma levels via enzyme induction, potentially compromising seizure control when topiramate is added to phenytoin therapy.
Механизм
Phenytoin is a potent CYP3A4 and CYP2C19 inducer that increases topiramate metabolic clearance by approximately 48%.
Клиническое значение
Topiramate levels may be halved by phenytoin co-administration; dose adjustments are typically required to maintain therapeutic effect.
Тактика ведения
Monitor seizure control and topiramate levels; titrate topiramate to therapeutic effect with awareness of enhanced clearance.
Медицинский отказ от ответственности
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